Why Do Tendon Injuries Take So Long To Heal?

Why Do Tendon Injuries Take
So Long To Heal?
If you’ve ever suffered from a tendon injury you will know
that the recovery can be frustratingly long. Tendons are
important tissues of the body, connecting muscles to bones and
come in many different shapes and sizes. There are many
reasons why tendon injuries can be difficult to treat, as we
explain below.

Tendon injuries often develop gradually
Tendons need to be able to transmit forces from muscles to the
bones that they attach, however they respond to changes in
strength more slowly than muscles do. As muscles become
stronger or take on more load, the tendons can fail to keep up
with this increased demand becoming painful and damaged. This
process can take a while to occur and often changes to tendon
tissue has begun long before the pain is noticed. This means
that there are likely to be multiple factors to be assessed,
including biomechanics and training regimes before the problem
can be resolved.

Tendons have limited blood supply
Tendons do have their own blood supply, however, it is not as
abundant as muscles. This can be a factor with healing, as all
tissues require nutrients for health and to heal. Any
condition that compromises circulation, such as diabetes, can
predispose tendons to injury and delayed healing.

Rest and stretching may not necessarily
help
Our instincts in response to tendon pain may not help with
recovery. In some cases, stretching can aggravate symptoms and

while rest may reduce symptoms, it will not necessarily help
with recovery. The best evidence for promoting healthy tendon
growth is through addressing poor biomechanics and a tailored
strength and loading program.

Recovery often relies on adherence to a
specific rehab program
One of the biggest barriers to healing tendon pain is that
exercises can be easy to do in theory, but hard to do in
practice. They can take time and discipline. Your
physiotherapist can also help you to find strategies to fit
your exercises into your daily routine if you are finding this
difficult.

Contact your local clinic to make an appointment with one of
our Physiotherapists to discuss how you can help reduce and
manage your tendon pain.

None of the information in this article is a replacement for
proper medical advice.

5 Physio                   Tips      for        Better
Running
Distance running can be a surprisingly complicated sport. In
this article, we offer some words of wisdom from our
physiotherapists to help you get the most out of your training
and avoid injuries.

1) CHOOSE YOUR SHOES CAREFULLY
    Repeated stress from running long distances will show up
    any biomechanical flaws in your body relatively quickly.
    Choosing the wrong shoes can worsen an existing problem
    causing pain and injury. Your physiotherapist can guide
    you on what style of shoe will best suit you.

2) DON’T NEGLECT YOUR UPPER BODY
    While running can appear to be a purely leg based
    activity, increasing the strength and mobility of your
    upper body can have a surprisingly large impact on your
    posture, running style, breathing and overall
    performance.

3) FIND TIME TO TRAIN STRENGTH AS WELL AS
ENDURANCE
    Your body is great at finding ways to compensate for
    weak muscles, however, overtime this can lead to overuse
    injuries of tendons and muscles. Identifying any areas
    of weakness early and specifically strengthening these
    muscles can both improve your running and help keep you
    injury-free.

4) PACE YOUR PROGRESS
    Entering an event is a great way to set a specific goal
    and keep you motivated. While trying to increase
    distances and speed, it is easy to forget to include
    rest days as a part of your routine. Your body needs
    time to recover and restore itself, just as much as the
    active portions of your training program. Increasing

your speed and distances gradually also allows your body
     to adapt to new demands without breaking down.

5) ENJOY TRAINING AND LISTEN TO YOUR BODY
     Your body will guide you as to when you need to rest and
     when you can push a little further. Training will be
     more enjoyable when you are well-rested and pain-free.
     Most importantly, if you are able to enjoy your runs,
     this will help you maintain motivation over a longer
     period of time, so you can continue for many years to
     come.

Contact your local clinic to make an appointment with one of
our Physiotherapists to discuss how you can reach your running
goals while staying injury-free.

None of the information in this article is a replacement for
proper medical advice.

SPOTLIGHT ON: Amy Decker –
Physiotherapist
In our latest ‘SPOTLIGHT ON’ series, we sat down with Amy
Decker, Physiotherapist at our Langwarrin clinic. In our
chat, Amy talked to us about working with St Kilda Football
Club’s AFLW team and how she stays at the forefront of her
field.

What area of Physiotherapy most interests you?
An interest area of mine would be bridging the gap between
rehabilitation and returning to sport – I believe there is a
large gap and often not an appropriate and safe transition
during end stage of an individual’s injury.

What has been your greatest professional
achievement in the last 5 years?
I’m privileged enough to have two equally great achievements
which are travelling to the Gold Coast as a part of the track
and field Commonwealth Games team and working with St. Kilda
Football Club with the AFLW team.

What professional development have you undertaken
to ensure you stay at the forefront of the latest
techniques and treatments?
I’m a strong believer that as a physiotherapist if you think
you know everything about injuries you are in the wrong field.
Treatments and evidence are forever changing and there are
always different techniques to learn. I achieve this through
podcasts, courses and shadowing highly experienced
physiotherapists in addition to studying my masters in sport.

What is one thing that everyone should be doing
for injury prevention?
Prevention is the key to injury management and therefore is
strongly important to complete mobility and activation prior
to playing/training/ working out to achieve the best outcome.

What is your favourite part of your job?
Definitely my favourite part would be when a patient has
achieved their goal whether that be taking the court/field for
the first time after an injury or lifting up their grandchild.
The happiness in the patient’s voice and face – that’s why I
continue my job.

If you could be in any movie, what would it be?
Avengers – So I could have super powers!

To make an appointment with Amy you can BOOK ONLINE or
call Langwarrin Sports Medicine Centre on 03 9789 1233.

2018   Commonwealth    Games
Physiotherapist, Amy Decker
By Amy Decker, Physiotherapist, Langwarrin Sports Medicine
Group

From 15,000 applicants applying for 1,400 medical positions
including Doctors, podiatrists, nurses and dentists it was an
honour being selected as a Physiotherapist at the 2018 Gold
Coast Commonwealth Games.

Like many within our profession, working with elite athletes
is a career goal, hence there was no second-guessing if I
would apply over a year ago to be selected.

When asked what was the one highlight of my experience, it was
difficult to answer. I have created many new friendships in
volunteers and staff, watched the best of the best train and
race but there were two moments that stood out.

Firstly, an Olympic athlete with a chronic low back stress
fracture. Unfortunately she lived in a country less fortunate
in medical treatment and had been suffering with low back pain
for over six months, continuing to train at a high intensity.
Upon coming to the games she was diagnosed through an MRI with
a stress fracture and was advised to rest. Her coach, however,
wouldn’t take this for an answer arguing they had invested
money and time into her competing which seemed more important
than her health.

The athlete received daily treatment to ensure her pain was
managed liaising with the sports doctor and physiotherapists
as she went on to compete. Knowing I helped assist in reducing
an individual’s pain and resulting in        an   increase   in
performance makes your job worthwhile.

On a complete different note, I was lucky to assist the para
athletes aswell. Listening to their stories definitely pulls
your heartstrings. Coming from an up bringing that included
second hand clothes, no supportive wear, no shoes, no coach
and training for javelin with sticks to earning yourself a
medal at the Commonwealth Games is a story I will remember.

After sustaining such a life changing injury and continuing to
be the best you can, inspired me both personally and
professionally. Success doesn’t come from what you can do, it
comes from overcoming the things you once thought you were
unable to do.

Would I volunteer a gain, heck yes I would! It was both an

invaluable and memorable experience that I would recommend
being a part of and I am thankful for being selected.

To make an appointment with Amy at Langwarrin Sports Medicine
Centre, please call 9789 1233 or BOOK ONLINE.

2018   Commonwealth                             Games
Physiotherapist,                               Daniel
Browne
By Daniel Browne, Physiotherapist, Langwarrin Sports Medicine
Group

Since 1930, every four years the Commonwealth Games are held
to both celebrate and test the athletic ability of the
countries residing under the Commonwealth of Nations. This
year the Commonwealth Games were held up in the Gold Coast in
Queensland from the 4th-15th April.

This marked a significant milestone in Commonwealth Games
history, as it was the first event to have an equal number of
male and female athletes competing, as well as the inclusion
of para athletes within the main time slot of the able bodied
athletes. This provided much needed exposure and the tens of
thousands of crowd patrons the opportunity to experience

something special that otherwise may have flown under the
radar.

In total there were more than 6500 athletes and team officials
from 71 nations and territories competing in 18 sports, and 7
para sports with a total audience of 1.5 billion.

Through an extensive application process I was afforded the
opportunity to lend my skills as part of the Medical team at
the Carrara Complex. This included work with the
weightlifting, para- weightlifting, badminton, wrestling as
well as liaising with the athletics medical team.

Each team comprised of a sports doctor, physiotherapist,
sports masseuse and sports trainer entrusted with providing
care to both on field incidence, between game management and
overall rehab day to day. Day to day challenges included
interactions with athletes, team officials, technical
officials as well as the sport specific and country specific
medical personnel.

                    A particularly warming tale came on my
                    second last day treating a female
                    badminton athlete from Fiji. She formed
                    one half a doubles duo that was an
                    outside chance for a medal going into the
                    round of 16. Clinically it appeared she
                     had a significant high ankle sprain, but
                     she was desperate to play for herself,
                     her country, but most of all for her
                     doubles partner. After what seemed like
                     100 conversations with her, the games
staff, her coach and her team doctor – all while her partner
frantically sprinted up and down the court behind us eagerly
keeping an ear out – I was able to support her ankle in such a
way that would give her enough pain relief to play and
function so as to not significantly increase her risk of
injury. She played, and won. Afterwards she was a bit tender,

but ecstatic that she was able to move through to the next
round which was the following day. I handed her over to a
treating practitioner at athlete’s village and left feeling
positive about the whole experience. I followed up with her
the next day after competition. She unfortunately lost the
next round, but her ankle was feeling ok. My reward was a
Fijian pin (the secret currency of Commonwealth and Olympic
games).

Looking back on my experience now, I am glad that I took the
time to head up to the Gold Coast and volunteer for 2 weeks.
It gave me the opportunity to be part of something bigger then
myself. To help other athletes achieve and most importantly
participate in something that they have spent their life
working towards is both a humbling and empowering experience.
I would encourage everyone to check out the Commonwealth Games
next time in Birmingham, England 2022.

To make an appointment with Daniel at Langwarrin Sports
Medicine Centre, please call 9789 1233 or BOOK ONLINE.

What to do about pain at the
front of your ankle?
Anterior ankle impingement, also known as anterior impingement
syndrome, is a musculoskeletal condition where repetitive
forces compress and damage the tissues at the front of the
ankle, causing pain and stiffness.

It is a common injury that can affect people of all ages,
however is usually seen in athletes of sports involving
repetitive or forceful upward movements of the ankle, such as
sprinting, landing from long jump, uphill and downhill

running.

What are the symptoms of an anterior ankle
impingement?
Pain at the front of the ankle is the primary symptom of
anterior ankle impingement. This can be felt as an intense,
sharp pain occurring with movements or a dull ache in front of
the ankle following periods of exercise. Pain can also be felt
when putting weight through the ankle while standing, walking
or running. Night-time aching, stiffness, swelling and reduced
flexibility are also common symptoms.

How does it happen?
                       Anterior ankle impingement is caused by
                       traumatic or repetitive compression to
                       the structures at the front of the ankle
                       as the tibia and talus move towards each
                       other during movements. The tissues that
                       are affected become damaged and inflamed,
                       causing the pain typical of ankle
impingement. Chronic inflammation can lead to further
stiffness, exacerbating the impingement process.

The most common risk factor for this injury is a previous
ankle sprain that was not adequately rehabilitated, as this
can result in a stiff or unstable ankle. Another cause of
impingement is the growth of small osteophytes or bony spurs
around the ankle joint that press against the nearby soft
tissues. These can be due to osteoarthritis or grow as a
reaction to impingement itself. Training errors, muscle
tightness, unsupportive footwear and a hypermobile ankle have
also been shown to be risk factors for anterior ankle
impingement.

How can physiotherapy help?
Depending   on   the   cause,   mild   cases   of   anterior   ankle

impingement usually recover in one to two weeks with rest and
physiotherapy intervention. For more severe impingement, the
ankle may require up to six weeks of rest and rehabilitation
to recover. In rare cases, surgical intervention will be
required to remove any physical causes of impingement, such as
osteophytes to restore impingement free movement of the ankle.

Your physiotherapist will first identify the cause of your
impingement and help you to choose the best course of action
to reduce your symptoms. They are able to advise you on the
appropriate amount of rest and provide stretches and exercises
to restore strength and flexibility to the ankle.

Mobilisation techniques and range of motion exercises can also
reduce stiffness, restoring normal joint movement. Moreover,
balance and proprioception exercises are included to prevent
further injury. Balance exercises challenge the way your body
reacts to outside forces. With this, your balance will be
improved, and you’ll have a more stable ankle.

Ideally, physiotherapy treatment is the first step before
considering surgery. If surgery is required, your
physiotherapist can help you to make a full recovery with a
post surgical rehabilitation program.

For more information or to make an appointment you can BOOK
ONLINE or call your local clinic.